DEVELOPMENTAL REPAIR: A Training Manual

1 DEVELOPMENTAL REPAIR: A Training ManualAn Intensive Treatment Model for Working with Young Children Who Have Experienced Complex Trauma and Present with Aggressive and Disruptive Symptomsby Anne Gearity, PhD, LICSWA cknowledgementsThis Manual reflects the work of many people over many years. Anne Gearity, PhD, LICSW, the author of this Manual , has been the theoretical and clinical leader of this effort for more than a decade. Dr. Gearity s consultation and Training at Washburn Center for Children has provided the conceptual basis for a different understanding of the young children who are often treated in Day Treatment Programs.

2 Her influence on how treatment is done at Washburn Center and on the children and families served has been project was also supported by Tom Steinmetz, , Chief Operating Officer, and by Arlene Schatz, LICSW, Clinical Director. The daily implementation and supervision of the program has been led by Lauren Nietz, LICSW, Matt Witham, LMFT and Joel Hansen, LISCW as supervisors of Washburn Center s Day Treatment Program. In addition, the tireless work of the day treatment staff and interns has been critical as these staff members learned a new model while it was being developed and refined, then implemented with challenging young children and their families.

3 At this time Washburn Center benefits from experienced staff who are experts in the DEVELOPMENTAL repair project would not have happened without multi-year funding from the Archibald Bush Foundation that supported the development of the program model and the evaluation design. Jane Kretzman, while serving as the program officer at the Bush Foundation, was an enormous resource; supporting and strengthening this work as the project evolved. In addition, sustained grant support from the McKnight Foundation, the Cargill Foundation, the General Mills Foundation and Allianz enabled the model to be implemented when traditional payments for treatment were not adequate.

4 Optum, Blue Cross and Blue Shield of Minnesota and Hennepin County provided additional support as Beuhring, PhD, while at the University of Minnesota s Institute on Community Integration, was an early evaluator of this project and was an integral part of the team that developed the evaluation framework and design for this effort. Yvonne Pearson edited early drafts of this Manual and Lora Joshi, president of Aajo Design, did the creative Advisory Council members Stuart Hauser, MD, Joseph Spinazzola PhD, Dee Wilson, PhD, and Leslie Koplow, MS, CSW, helped shape the work of this project. Local Advisory Council members Glenace Edwald, PhD, PsyD, LP, Mark Sander, PhD, LP, Kristine Martin, MSW, LICSW, Jim Baxter, PhD, CPHQ, CBHE, and Matt Eastwood, PhD, MPA, LP, LMFT added significant value as the project developed.

5 This treatment model was implemented at Washburn Center for Children, a children s mental health agency serving Minneapolis, Minnesota since 1883. The challenges of implementing and evaluating new research and new models in a community setting are many. The Board of Trustees of Washburn Center for Children recognized the importance of this effort and supported the organizational and financial framework which enabled this project to the fall of 2014, Washburn Center for Children completed a $ million capital campaign and occupied a new 56,000 square foot building. The facility was designed to house the programs at Washburn Center and the Day Treatment Program now has a more appropriate space in which to treat young the DEVELOPMENTAL repair model has been developed and refined, Dr.

6 Gearity and Washburn Center staff have done extensive Training both locally and nationally on this model. In Minnesota, DEVELOPMENTAL repair has become the community standard for treating young children who have experienced chronic a 2015 publication, Prioritizing Early Childhood to Safely Reduce the Need for Foster Care: A National Scan of Interventions, the Casey Family Programs recognized the DEVELOPMENTAL repair model as a promising , a special thank you to the hundreds of children and families who have participated in the Day Treatment program at Washburn Center. Their courage, resilience and growth are inspiring and what have motivated this effort over the last 10 years.

7 Steve Lepinski MHA | Chief Executive OfficerWashburn Center for Children | July 2015 Author s PrefaceThis Manual is the work of many creative and dedicated people. While I did the actual writing, the ideas and interventions for DEVELOPMENTAL repair came from collaboration with Washburn staff, and with the children and families who came to us seeking help. These children taught us how their behaviors were their best efforts to manage painful emotional dysregulation. Their families taught us how hard it can be to raise children without positive community support. Washburn staff experienced dysregulation contagion, and then became interested in thinking about these children, and regulation, differently.

8 While DEVELOPMENTAL repair has been designed as a group treatment model for young children, many of these ideas are applicable to children of all ages, in individual and community settings. Writing a Manual is a daunting task: to reduce complex clinical processes into clear instructions that capture the richness of interactions that very at risk children need. I have tried to illustrate this richness in two ways. One is with my use of we: I wrote descriptions of our collective experiences as we conceptualized this repair model. I also provided examples of specific language and actions we used to join children and help them join us.

9 These children have experienced complex trauma, described as the pervasive negative impact of chronicor repetitive traumatic experiences, including too little adult protection. One child in our programlamented, I don t want it to be all my fault. These children cannot be blamed or asked to solve their difficulties alone. DEVELOPMENTAL repair is a framework for interventions that help children access new learning and positive community support so they can heal and building this model, I was also supported. I am especially grateful to Jane Kretzmann, our grant officer from the Bush Foundation in St.

10 Paul. Jane moved us farther than any of us imagined we could go. This Manual was initially her idea. To Stuart Hauser, MD, of Harvard University and Judge Baker Children s Center, who provided invaluable guidance and encouragement until his untimely passing in 2008. This Manual honors his conviction that resilience is possible when adults help children. To Tom Steinmetz, who was the first change agent in this program transformation and continues to champion improvement throughout Washburn and in the community. And to Meghan Kimmel whose editing moved my manuscript from confusion to coherence.